We LOVE FDM here, and we are becoming known for the residency that trains their residents in this great model! I am the Osteopathic Program Director and DME for our program, and initially struggled with how to fit Osteopathic manipulation into practice. I have always felt that I am a family doctor through and through, and thus never liked the idea of “OMT procedure” days, or even having separate OMT appointments for myself or the residents. My goal for each resident (MD/DO) that comes through our program is to be able to adequately address the needs of the patient AT THAT VISIT if possible. I view OMT as another tool in my pocket. In reality, this is where FDM is key. I can have a diabetic, hypertensive patient come in for a 15 minute visit, and when his agenda is for back pain, and my agenda for him is chronic disease management, we can EACH have our goals met! We quickly treat his trigger band or Herniated Trigger Point (HTP), and there is still time to take care of his chronic disease during the visit. FDM allows us to address the concerns of the patient – ankle pain, back pain, headaches, etc. – at the time of the visit. So, we love it. Every resident knows how to do it thanks to Dr. Todd Capistrant.
Erin Westfall, DO, Osteopathic Program Director/Osteopathic Director of Medical Education, University of Minnesota Mankato Family Medicine Residency Program. Assistant Professor, University of Minnesota Medical School Department of Family Medicine and Community Health. Mayo Clinic Health System – Mankato
Before being introduced to FDM, I felt that my hands were tied when treating patients with complaints of pain...NSAID's, the occasional opioid medication, and physical therapy were my only options. Now that I have attended the FDM modules, I am able to offer many patients the options of treatment right there in my office and often with immediate improvement in their pain! This has been a game changer in my practice. I now feel empowered to help my patients and it gives me something I can actually do to help them right then that doesn't just involve a prescription (which is great for me and for the patient!). And the feeling that I get when a patient looks at me and says, "OH! The pain is gone!" or "WOW! Look how far I can turn my neck now!" is amazing. It's that instant gratification of helping patients heal.
Kathryn Potter, MD - SparkMD
My perspective on the FDM is unique in that I have been introduced to the model as a student. In school we are bombarded with information and told to treat the patient as a whole. As a student and novice practitioner this concept sounds great, however, the schools proceed to teach us in segments. We are taught in anatomy and biomechanics about specific muscles, joints, bones, ligaments, etc. and it is all broken up into parts. We are taught special tests and manual techniques that are specific for certain muscles and joints or regions. This works great when we see "textbook" patients. What about the patients who don't respond to traditional treatment? Who show strange or bizarre symptoms or who continually complain of a nagging symptom? This is where the FDM has helped me to become more confident as a student because I have seen the results of treatment on others and myself.
The FDM is different because restores the model of treating the whole patient back to the forefront of our focus. Due to the nature of fascia being the connective tissue between all cells you really can't say where it starts or ends. This provides us as PTs to, instead of focusing on segments to treat the "whole", we actually have a model and an explanation into how we can treat the "whole" every visit.
I learned the fascial distortion model on my last clinical rotation in school and find myself thinking of patients at old clinical sites and patients that I wish I could go back and treat again using this model. The fascial distortion model has also helped me think about the prognosis of patients very different. From what I have seen my expectations on recovery time have changed. I expect to see patients for shorter treatments and for fewer treatments.
The FDM model is a very powerful tool to have as a PT or MD. The treatments are quick and effective. When I first started learning the model I was somewhat skeptical, but I decided that even if I don't understand it I can try and use it because a single treatment only takes about 15 minutes and the results should be dramatic and immediate so I thought to myself 'why not try?' Another aspect that I have enjoyed about the FDM is that it is a model for MDs and DOs to use. This isn't a physical therapy model being adapted to them. As more DOs, MDs and PTs learn this it allows us to share similar language and understanding which improves the MD to DO to PT relationships which benefits the patient overall.
I have had the privilege of being the first physical therapy student to attend a class and receive formal training. Needless to say this model is young. The RCT studies don't abound when it comes to FDM. To a student in an evidence based practice heavy program this didn't appeal to me. After learning the model and seeing the results this is evidence one form of evidence that so far has been very convincing. I have learned that FDM is an effective and very powerful tool to have on my belt as a health care provider, and I am grateful that I have gained such a tool early into my career.
Anson Call, PT, DPT
I thought I’d share a jaw-dropping success. 48 yo female with 3 R shoulder surgeries over 5 years (RTC repair, SAD, bicep tenotomy) coming in with worsening pain and ROM over past 3 months. Referral was for adhesive capsulitis and wants to try PT before exploring other surgical options. Pain rated 10/10 at eval, only able to reach to 80 deg flexion limited by pain. PROM limited by pain and muscle spasm at 100 deg. In traditional model I’m thinking several weeks first to control pain, severity and irritability, then progressing ROM and strength, maybe joint mobs when she can tolerate. However she showed CD’s at anterior and posterior shoulder, and 1 TB anterior shoulder. Treated those 3 distortions in less than 5 minutes. She left the eval with 3/10 pain and 150 deg AROM flex & Abd! Two days later she had 1-2/10 pain and 160 deg elevation! I still am shaking my head.
Lesson I have been learning is not to be afraid of treating the distortions that the patient shows. After a little education and building rapport, she was willing (and very ready after 5 years of pain) to let me treat those distortions even though she was “10/10” pain.
Corey DuPont, PT, DPT
"FDM is a model of diagnosis and treatment which finally gives the fascial system the attention it deserves. As the former dean of the Pacific Northwest University College of Osteopathic Medicine, where FDM is taught as a part of the Osteopathic Principles and Practice curriculum, the faculty and I were impressed with how quickly students grasp these concepts and utilize the skills which Dr. Capistrant shares in this engaging and informative book. The principles of this model need to be understood and applied broadly for the benefit of patients who have suffered with the consequences of fascial injuries."
Robyn Phillips-Madson, DO, MPH, Founding Dean of the University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX. Associate Professor of Family Medicine
As an allopathic physician I have found myself frustrated, too many times to count, with patients whose pain descriptions and patterns do not fit the traditional dermatomes we all learned in medical school. Muscle relaxants, anti-inflammatories, and even pain medications oftentimes were not successful in healing my patients, and physical therapy offered only partial or temporary relief. Fascial distortion model offers a new tool in "our black-bag" for helping to evaluate and manage pain. It offers explanations for complex pain questions that traditional medical teaching does not explain. It has revolutionized my practice!
Grayson. T. Westfall, MD Director 1st care Tanana Valley Clinic
The FDM has been a tremendous addition to my musculoskeletal rehabilitation clinic. I was already utilizing OMT with approximately 95% of my patients. Since adding FDM to my hands-on treatments I have been able to accurately diagnose and treat conditions that may have escaped traditional allopathic and osteopathic approaches. I have also been able to effectively treat patients that I would have previously needed to initiate trigger point or prolotherapy injections. My amazement with the results continues to grow as do my FDM skills.
As one of the foremost experts and teachers of FDM, Todd Capistrant D.O., has traveled nationally and internationally for conferences and teaching of the FDM. His book, Why Does It Hurt? presents an efficient introduction of the model for everyone from physicians to patients.
Drew Lewis, D.O. Diplomat AOBPM&R, FAAPM&R Board Certified in Physical Medicine and Rehabilitation Assistant Professor, Osteopathic Manual Medicine Department Des Moines University
"As a pediatric physical therapist, I have seen great changes in my young patients using gentle FDM techniques, improving pain response and movement in as short as a few minutes of treatment. Immediately after the FMD level 1 course, I applied the techniques to an infant with a severe post-operative abdominal scar. Prior to the treatment the baby could not bend forward at the waist or tolerate being placed on hands and knees. After a few minutes of treatment, he was vigorously bending over in supported standing to retrieve toys off of the floor, and he stayed on his hands and knees for over a minute. The baby returned four weeks later and was crawling and pulling to stand. This outcome is extraordinary.
I see a high number of babies with torticollis in my practice and apply the FDM techniques to these little ones with response of immediate full head rotation to the non-tolerated side. FDM has increased my tool kit for pediatric practice and is improving my outcomes."
April Milan, PT, DPT, PCS, CSCS, CIIM
“I just had the pleasure of hosting Module 1 of the Fascial Distortion Model at the Alabama College of Osteopathic Medicine and all that I can say is Thank You to Dr. Capistrant for expanding my love for Osteopathic Medicine by teaching me another way to pragmatically approach clinical care of my patients and teaching our students rooted in FDM’s common sense approach. Additionally, he positively lit an Osteopathic fire in my students who attended the work-shop because of his clinical acumen and engaging teaching method. I recognize myself as a perennial student but was further humbled by the clinical demonstrations of FDM that were presented during the work-shop. I am incorporating the Fascial Distortion Model into our OMS 1 & OMS 2 OPP Curricula for the palpatory, gestural and verbal cues rooted in FDM’s MO which is “the patient is the expert”. I will be encouraging them to enroll in the Modules throughout their medical school – residency – clinical years to learn from a content experts. One of my favorite ideas from Dr. Still is part of the inspiration of FDM as I understand it: “I know of no part of the body that equals the fascia as a hunting-ground. I believe that more rich golden thoughts will appear to the mind’s eye as the study of the fascia is pursued than of any other division of the body.”-A T Still (Philosophy and Mechanical Principles of Osteopathy)”
Kevin Joseph Hayes, DO
AOBFP and AOBNMM
Chair of Osteopathic Principles and Practice at the Alabama College of Osteopathic Medicine &
Osteopathic Medical Director of the OPP Clinic at SAMC NeuroSpine
The Fascial Distortion Model workshop you put on for us at WVSOM was not only of great clinical value but a very useful Model for assessing and treating fascial pain and discomfort. The simplicity and ease of being able to have an FDM Academy workshop on our campus was amazing. All we had to do was pick a date and you all did the rest. We just showed up and benefitted by the hands-on experience. Thanks, and we look forward to the next one this Fall.
Robert W. (Bob) Foster, D.O.
Assoc. Dean for Osteopathic Medical Education
Professor of Family Medicine and Osteopathic Manipulative Medicine
West Virginia School of Osteopathic Medicine